Thursday, May 30, 2013

Times are tough for doctors these days. No one gives a shit, so I'm not elaborating further.

But even big institutions are affected. Take, for example, the venerable MD Anderson Cancer Center in Texas. This giant of oncology has recently been having financial issues, so much so that its president, Ronald DePinho, sent out this e-mail to employees 2 weeks ago:

"For most of fiscal year 2013 our operating expense has exceeded our operating revenue - meaning that we've spent more than we've made from providing patient care services."

He went on to say that because of this shortfall MD Anderson is suspending merit raises and slowing its hiring rate. This is what they call "austerity measures."

At the same time Dr. DePinho is preaching financial restraint for his cash-strapped institution, he's used $1.5 million of its capital funds (which come from investment income, donations, and patient revenue) to build a 25,000 square-foot (2,322 square meter) office suite for Dr. Lynda Chin at the institution.

Who just happens to be his wife.

Really. I am not making this up.

Dr. Chin is the scientific director of MD Anderson's Institute for Applied Cancer Science. How this justifies her having an office suite that is 10 x larger than the average American home is beyond me. According to the institute it's to "provide an appropriate meeting space with high-level industry decision makers and support a new suite in computational biology." Translation: By using a lot of syllables we're hoping you'll ignore what's really going on here.

And no, I have no idea what "computational biology" is. Maybe that's why my entire office is 1,250 square feet, including the john.

According to an itemized expense report (obtained by The Cancer Letter under the Texas Public Information Act) this ginormous office has $28,000 worth of chairs, sofas, and tables. They also spent $210,000 on fancy translucent glass walls, which required them to get a special permit from the University of Texas. By comparison, the Grumpy Neurological Emporium has used furniture (valued at $948 total), and plain old painted drywall.

I'm going to close with another quote from Dr. DePinho, found in the same e-mail I quoted earlier about the austerity measures MD Anderson will have to take to survive:

"If we don't make changes now, we potentially will find ourselves in a crisis that will force us to take drastic measures that could hurt our ability to meet our mission... [all will] have to share sacrifices."

Sounds like what is going on at the average American university. Pay raises for administrators (the average university president makes over 400K) and those providing services professors that are full time tender track make on average 80K if you can find a tender track position since most schools in order to save money use part time instructors where they don’t have to pay the benefits.

Computational Biology is a thing, most often involving machine learning techniques applied to biological research. It can be quiet effective at discovering causation mechanisms that are particularly complex or involve poorly-understood systems such that we can't trace the causal pathways backwards.

Essentially, it's Big Data for the body. The hardest part is finding programmers that Google isn't already paying more than the GDP of a small country to actually program the stuff.

My husband was given the same speech in a meeting with the hospital big wigs. Furthermore, there is now a hiring freeze on new MDs. That means my husband will not be able to replace the surgeon who he had "fired". Great. As for that office BS? .......BASTARD!

The Board should not have allowed such frivolous, and outlandish spending. Unfortunately, there is an almost incestuous "I'll scratch your back if you scratch mine" culture between Boards and presidents. And by the time new board members and a new president is elected, it will be too late to recoup any of the money already spent on that office suite, and the new board will be just as corrupt as the exiting board.

Sue: From a company called Broadsword (1-800-514-9773) that advertises widely. I suppose it could be a scam? Or a state program? Although the latter sounds unlikely since I live in a state whose governor hates to spend money to the point that he gutted our EPA funds because "climate change is an unnecessary distraction." If only I could do that to my electric bill.

Sometimes I feel like a douche for seldomly donating to "research" organizations, but then I see things like this and I feel justified. Granted, I don't think that all research organizations behave this way (just let me be Polly Anna-ish about this), but these stories justify my stinginess with these orgs.

Here's a link to the compilation of documents: http://www.cancerletter.com/downloads/20130523/download It's laughable that MD Anderson would defend spending $1.5 million on an office suite by stating that two-thirds of it was for lab equipment. Page 78, and at least a couple of other pages, of the lengthy compilation has nothing to back up their claims.

Computational Biology is what it sounds like, applying computers to biology.

Computational Biology is and has been used for things like: Mapping the genome, trying to predict the growth of cancers, studying the neurology of the brain and looking at real-time examples of how things work, and more.

I used to work in Supercomputing and we had a whole division of Computational Biologists -- people with Ph.D.s in biology who were also expert programmers, who worked with researchers to develop software to do all of the above and more.

About 15 years ago they did a live demo over the internet of a brain MRI during an experiment to see what areas reacted to various verbal and visual responses. At the time it was completely groundbreaking to think that your patient could be thousands of miles away while you looked at a live MRI of their brain.

Sort of like certain people in charge of the whole USA (nameless of course) who tell us to conserve fuel and save money while they fly their entourages all over the world on vacation after vacation. At our expense. And send a plane for the dog so HE can go on vacation, too.

ONE example of a reference explaining that it is NOT true that the kids of elected officials don't have to repay school loans. A simple google check on this kind of information will keep you from spreading falsehoods...sheesh.

The thing about public servants not paying back their loans seems to be an exaggerated account of Public Servant Loan forgiveness.

In 2007, Congress created the Public Service Loan Forgiveness Program to encourage individuals to enter and continue to work full-time in public service jobs. Under this program, borrowers may qualify for forgiveness of the remaining balance due on their eligible federal student loans after they have made 120 payments on those loans under certain repayment plans while employed full time by certain public service employers.

To add insult to injury, apparently MD Anderson is particularly aggressive about getting payment from patients - they were the first example in the TIME article:http://readersupportednews.org/opinion2/272-39/16241-time-why-medical-bills-are-killing-us

This needs to be on the front page of the "New York Times." We wonder why there are absolutely no cures for any diseases.

There is corruption in medicine, as anywhere else. Many in the field have missed their calling as politicians. Cinch your belts tight your peonic underlings and try hard not to starve as we magnanimously allow you to eat cake. It's the MD Anderson way. Yes, we believe in research, improved treatments and cures. FAIL. Gag.

I work for a hospital in Connecticut and the state has for some years been "taxing" hospitals, using those "taxes" to get matching federal money, and then returning both the "taxes" and the matching funds to the hospitals, all to pay for the care of uninsured/underinsured patients. (Of something like that. It's very confusing.)

We're so broke as a state that they've decided not to return any of the money to the hospitals. (They need it, not to pay off the massive deficit, but to pay for new entitlement spending.)

There was a local town-hall type meeting a few months ago at which some of hospital admin pointed out how damaging these cuts would be. (Over $10M per year for us, and we're a small, community hospital). What wasn't reported in the paper and I heard about from a fellow staffer who was there, was the folks from state pointing out that we are a non-profit and some of our higher admin make seven figure salaries, so they assumed we couldn't be hurting that much.

Of course I've seen about a 3% total raise over the last 4 years, lost my employer health insurance since they dropped my plan, (the only plan I am now eligible for costs more than the family Tricare total out of pocket expenses for the year, so I'm saving them a ton of money I won't see a penny of), and they've cut my department budget 5% each of the last three years, except for last year which was a 15% cut.

Dear Dr. Grumpy:If a single office suite at MD Anderson was really larger than a house and many times the size of your office, your grumpiness would be understandable. However, that’s simply not the case for the renovation of 12,000 square feet of office and lab space to accommodate our Department of Genomic Medicine and our Institute for Applied Cancer Science.

Dr. Lynda Chin’s office is 187 square feet and the cost of her furniture was $20,251. This compares with 160 square feet and $15,000 for the average department chair at MD Anderson. Her suite includes a 121-square-foot meeting room and 124 square feet for office space for her assistant.

None of this is out of line for a scientist and leader who both chairs an academic department and serves as scientific director of an institute designed to improve the efficiency and speed of cancer drug development.

Dr. Chin is one of the world’s leading experts on cancer genomics, a crucial field that is helping us better understand abnormalities that drive tumor survival and growth in order to better treat and prevent cancer. She is a member of the Institute of Medicine of the National Academies and serves in leadership roles for The Cancer Genome Atlas (TCGA) of the National Institutes of Health and the International Cancer Genome Consortium.

Out of this $1.5 million renovation project, $547,434 covered furniture and renovations for 9,000 square feet of space for multiple offices and meeting rooms for IACS and the department. The balance of about $900,000 was invested in converting biology labs to chemistry labs by adding fume hoods and modifying mechanical, electrical and plumbing to accommodate that use.

Planning for this renovation began in the fall of 2011 and the project was completed in 2012, so it’s unrelated to MD Anderson’s current fiscal challenges. Many thanksScott MervilleExternal CommunicationsThe University of Texas MD Anderson Cancer Center

I don't know about the others, but only people who sign up to teach in low income schools get their loans covered out of all teachers. So they have to commit to doing what is essentially community service for a certain number of years before they can have their student loans forgiven.

Grumpy, when are you going to retract this story since it's obviously bullsh*t? Did you honestly think she had a 25,000 sq ft office? A bit gullible aren't we? Be a man and admit you were wrong. But you won't...it's too easy to hide behind a keyboard.

@Anon, 6/4. One error doesn't make the whole story bu11shit, and if you're not a follow on drone merely posting what your masters have to say, perhaps you'd care to point out what other errors contained within the post make it *all* bull5hit?

You might want to read the article in the local paper BEFORE you respond to this post:http://www.houstonchronicle.com/news/houston-texas/houston/article/During-tough-times-UT-OK-d-550-000-office-4570155.php

This does not jibe with the major Time Magazine story from February which included the following from author Stephen Brill:

"The hospital's hard-nosed approach pays off. Although it is officially a nonprofit unit of the University of Texas, MD Anderson has revenue that exceeds the cost of the world-class care it provides by so much that its operating profit for the fiscal year 2010, the most recent annual report it filed with the U.S. Department of Health and Human Services, was $531 million. That's a profit margin of 26% on revenue of $2.05 billion, an astounding result for such a service-intensive enterprise.

The president of MD Anderson is paid like someone running a prosperous business. Ronald DePinho's total compensation last year was $1,845,000. That does not count outside earnings derived from a much publicized waiver he received from the university that, according to the Houston Chronicle, allows him to maintain unspecified "financial ties with his three principal pharmaceutical companies."

DePinho's salary is nearly two and a half times the $750,000 paid to Francisco Cigarroa, the chancellor of entire University of Texas system, of which MD Anderson is a part. This pay structure is emblematic of American medical economics and is reflected on campuses across the U.S., where the president of a hospital or hospital system associated with a university - whether it's Texas, Stanford, Duke or Yale - is invariably paid much more than the person in charge of the university."

I'd like to hear the rep from MD Anderson defend or dispute this information.

Sounds like what is going on with Health Management Associates. No vacation accrual for the next 5 months and no pay raise in the last year or this year. Yet the CEO has an effective pay raise of 17% http://www.beckershospitalreview.com/compensation-issues/pay-package-for-hma-ceo-gary-newsome-climbs-17-to-83m.html

One of the ways they could cut costs is to stop sending us bills to show us that our balance is 0! My son is a patient there and every so often we get the same bill showing us that we have a zero balance. I have called and was told that this is routine. Can you imagine how much money this wastes?

I work at MDA, and I am kind of tired of the emails I have gotten from Dr DePinho about various scandals and how they aren't true. It started from the beginning of his presidency, and he has only been in this position two years! I wish he would step down; it is embarrassing.

Welcome to my whining!

This blog is entirely for entertainment purposes. All posts about patients may be fictional, or be my experience, or were submitted by a reader, or any combination of the above. Factual statements may or may not be accurate.

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